Patient services

Valley Neurology Group Bill Payment

Use the amount on your statement. Payment does not confirm insurance coverage or an appointment.

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ONLINE BILL PAYMENT

Valley Neurology Group Bill Payment

Enter the amount on your statement. Card details are handled securely by Square.

Patient & billing details

Patient first namePatient last namePatient date of birthPhone numberEmail address (optional)Billing / invoice information (optional)

Payment details

Amount to pay (USD)Name on card

Billing street addressCityState / provinceZIP / postal codeCountry

Signature for payment authorizationI confirm this amount and authorize this one-time payment to Valley Neurology Group. Payment does not confirm an appointment or insurance coverage.

Keep your receipt. If you are unsure whether a payment succeeded, contact our office before paying again. We never ask you to send card details in email or chat.

Submitting this form does not confirm payment until the payment has been posted and cleared. For follow-up, please call (661) 776-3876 during office hours: Monday–Friday, 8:30 a.m.–5:30 p.m. PST.